European journal of pain : EJP
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Chronic post-surgical pain (CPSP) by definition develops for the first time after surgery and is not related to any preoperative pain. Preoperative pain is assumed to be a major risk factor for CPSP. Prospective studies to endorse this assumption are missing. ⋯ All patients with CPSP reported on preoperative chronic pain. Patients with preoperative pain, related or not related to the surgical site were significantly at risk to develop CPSP. High preoperative pain chronicity stages and pain severity grades were associated with CPSP. CPSP patients reported poorer mental health related quality of life and more severe psychosomatic dysfunction before and 3 months after surgery.
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The aim of this work was to evaluate the psychometric properties of the Numerical Rating Scale-11 (NRS-11) when used to assess pediatric pain intensity. We performed two studies: 175 schoolchildren, aged 8-12, participated in Study 1 and 63 children undergoing surgery and aged 6-16, participated in Study 2. ⋯ While both sexes and both the younger and older age groups preferred the FPS-R, this preference was more marked among girls and younger children. The NRS-11 has shown an acceptable level of validity for assessing pain intensity in both samples, however, additional research is needed in order to fully clarify the lower age limit in which the NRS-11 can be used.
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Attention management is often included in cognitive-behavioural treatments (CBT). The aim of this study was to evaluate the effects of attention management strategies in the treatment for chronic pain. The present pilot study consisted of six weekly 90-min treatment sessions and was based on a CBT attention management manual describing techniques such as attention diversion, imagery and mindfulness exercises. ⋯ Reduction in pain-related interference and anxiety remained at the 6-month follow-up. The results indicate that attention control skills can be a useful method to reduce anxiety in the short term. Clinical implications of the results are discussed.
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The aim of this study was to investigate the effect of unilateral limb pain on sensitivity to pain on each side of the forehead. In the first experiment, pressure-pain thresholds and sharpness sensations were assessed on each side of the forehead in 45 healthy volunteers before and after a 10 degrees C cold pressor of the hand and in 18 controls who were not subjected to the cold pressor. In a second experiment, forehead sensitivity was assessed in 32 healthy volunteers before and after a 2 degrees C cold pressor. ⋯ The locus coeruleus inhibits ipsilateral nociceptive activity in dorsal horn neurons during limb inflammation, and thus may have mediated the ipsilateral component of analgesia. Pain-evoked changes in forehead sensitivity differed for sharpness and pressure, possibly due to separate thalamic or cortical representations of cutaneous and deep tissue sensibility. These findings suggest that several mechanisms act concurrently to influence pain sensitivity at sites distant from a primary site of painful stimulation.
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Although persistent postherniotomy occurs in 5-10% of patients, pathogenic mechanisms remain debatable. Since pre-operative pain has been demonstrated to be a risk factor for persistent postherniotomy pain, pre-operative alterations in nociceptive function may be a potential pathogenic mechanism. ⋯ Pre-operative groin hernia pain is not related to findings of hyperalgesia or other changes in sensory function that may support pain-induced pre-operative neuroplasticity as a pathogenic mechanism for the development of persistent postherniotomy pain.